Simple method to determine prevalence of celiac disease in children aged 2-4

Researchers from the University of Granada (UGR) have developed a new, simple and non invasive method which allows to determine whether a child aged 2-4 suffers from celiac disease or not without the necessity of a blood extraction.

Moreover, this method doesn't require experienced personnel (although it has to be interpreted by health professionals), is quick (10 minutes), economic (10-12 euros per device) and, most important of all in the case of infant population, this method is less invasive than a blood extraction.

This work has been carried out by Mª Vega Almazán de Bobadilla, researcher at the UGR department of Pediatrics, and lead by José Maldonado Lozano. Part of their results have been published in the Pediatric Research magazine.

As the author, pediatrician at the Health Center in Maracena (Granada, Spain), explains, "the idea of carrying out this research came from the need of responding to a question that I have considered when giving daily clinical care: is there any silent prevalence of the celiac disease in our field of specialization?".

Silent celiac disease

Silent celiac disease is that which goes unnoticed to the eyes of the doctor because it presents minor symptoms, imperceptible even for the patient. Celiac disease is a systemic disease caused by a permanent intolerance to gluten (which can be found in wheat, barley and rye), and it affects people with genetic predisposition. The symptoms are intestinal (intestinal malabsorption, abdominal distension, diarrhea, abdominal pain, etc.) and extra-digestive (skin problems, joint pain, cephalalgia, etc.).

Nowadays, in order to diagnose celiac disease, three things are required: clinical symptomatology, the assessment of celiac disease antibodies present in blood, and a compatible histological study via intestinal biopsy.

The goal of the research carried out by the University of Granada was to assess the prevalence of the silent celiac disease among children aged 2-4. For that purpose, the researchers used new devices which allowed to detect the disease markers (auto-antibodies) present in the patient's capillary blood.

"A puncture in the finger is enough to take a little drop of blood, which is then put in the device and, in case the subject suffers from the disease, a pink line will appear in the strip (just like in pregnancy tests). Said pink line means that there are auto-antibodies characteristic to the celiac disease present in blood".

A study carried out with 198 children

A positive outcome of the test will require further confirmation via blood extraction and assessment of the disease antibodies via other methods, but a negative outcome will allow to dismiss, with certainty, being affected by the disease. As we have proven during our research, a negative outcome in the strip lowered the probability of suffering from celiac disease to zero, given its high negative predictive value".

This UGR research allowed to detect 6 celiac children among the 198 who participated in the study (which means a very high prevalence of 3%, higher than the European mean). All of them presented no symptoms at all, or minor imperceptible symptoms which didn't make their parents consult a pediatrician.

The confirmation of this diagnosis was carried out at the Pediatric Gastroenterology Unit at the Virgen de las Nieves University Hospital (Granada), where those 6 patients underwent endoscopy and biopsy procedures.

"It's a novel research, given that there are few published works that use these devices in apparently healthy people, in Spain and the rest of Europe -Mª Vega Almazán stresses-. Counting with this kind of diagnostic methods in the family doctor's or the pediatrician's office would allow to find cases of celiac disease not diagnosed due to its atypical symptomatology, and to avoid unnecessary procedures, blood extractions or patient referral to specialized doctors".

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